Samuel Andrew Polek, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD.32824 Issued in AL

Practice address

128 N 2ND St Ste 202
Clarksville, TN 37040-6460

Phone

(866) 219-2688

Fax

(423) 523-0994

NPI assigned

May 18, 2010

Reactivated

Apr 18, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL, ME, NY, TN4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Psychiatry

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15315/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Care Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Franklin, TN
  • NPI 1124756085
  Medicare reassignment Care Compare group NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment NPD
• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1669423380
  Medicare reassignment NPD
• MCCD FL Psychiatry Services PA

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  AL, ME, TN

  Medicare reassignment NPD
• MCCD Psychiatry Services PLLC

  • Psychiatry Physician
  • New York, NY
  • NPI 1033750823
  Medicare reassignment NPD
• University of Alabama at Birmingham

  • Psychiatry Physician
  • Birmingham, AL
  • NPI 1811280654
  Medicare reassignment NPD
• Family Care Center, LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1598535288
  NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1285783134
  NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349

  Psychiatry

  NPD
• Mainegeneral Medical Center

  • Community/Retail Pharmacy
  • Waterville, ME
  • NPI 1477344976
  NPD
• University of Alabama at Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1447145818
  NPD
• Psychiatry 280 Counseling Services Inc

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Birmingham, AL
  • NPI 1285019927
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1790004646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 REDDICK RD",
            "city": "PALMYRA",
            "state": "TN",
            "postal_code": "371422141",
            "telephone_number": "256-499-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 N 2ND ST STE 202",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406460",
            "telephone_number": "866-219-2688",
            "fax_number": "423-523-0994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2803 Greystone Commercial Blvd Ste 12",
            "address_purpose": "LOCATION",
            "city": "Hoover",
            "state": "AL",
            "postal_code": "352429603",
            "country_code": "US",
            "telephone_number": "866-219-2688",
            "fax_number": "423-523-0994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLEK",
        "first_name": "SAMUEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-18",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "deactivation_date": "2018-03-27",
        "reactivation_date": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "MD.32824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Manfra Plotsky, PT,DPT
• Courtney Plunkett, DPT
• Holly Lynne Poindexter, RBT
• James Lee Poindexter, APRN BC
• Karen Pokrywczynski, MA
• Barbara Erika Polidura, M.S.
• Kailie Mechelle Pollard
• Alysa Marie Polley, OTD, OTR/L
• Zachary Pollock, PA
• Stacie Pommer

• Psychiatry Physician in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.